practice

family practice

or family medicine or general practice

Field of medicine that stresses comprehensive primary health care, emphasizing the family unit. Practitioners must be familiar to some degree with medical specialties and, especially in health maintenance organizations, are now often gatekeepers who refer patients to specialists when necessary. Once virtually the only kind of medicine, family practice has been defined as a separate field only since increasing specialization in medicine led to a shortage of practitioners. A 1963 World Health Organization report stressing the need for medical education to focus on the patient as a whole throughout life led to specific programs in family practice.

The term is derived from the original name of the goddess Sati also known as Dakshayani, who immolated herself, unable to bear her father Daksha's humiliation of her (living) husband Shiva. The term may also be used to refer to the widow herself. The term sati is now sometimes interpreted as 'chaste woman'.

Origin

Few reliable records exist of the practice before the time of the Gupta empire, approximately A.D. 400. Some instances of voluntary self-immolation by both women and men that may be regarded as at least partly historical accounts are included in the Mahabharata and other works. However, large portions of these works are relatively late interpolations into an original story, rendering difficult their use for reliable dating. Also, neither immolation nor the desire for self-immolation are regarded as a custom in the Mahabharata. Use of the term 'sati' to describe the custom of self-immolation never occurs in the Mahabarata, unlike other customs such as the Rajasuya yagna. Rather, the self-immolations are viewed as an expression of extreme grief at the loss of a beloved one.

The ritual has prehistoric roots, and many parallels from other cultures are known. Compare for example the ship burial of the Rus' described by Ibn Fadlan, where a female slave is burned with her master.

Aristobulus of Cassandreia, a Greek historian who traveled to India with the expedition of Alexander of Macedon, recorded the practice of sati at the city of Taxila. A later instance of voluntary co-cremation appears in an account of an Indian soldier in the army of Eumenes of Cardia, whose two wives vied to die on his funeral pyre, in 316 BC. The Greeks believed that the practice had been instituted to discourage wives from poisoning their husbands.

Voluntary death at funerals has been described in northern India before the Gupta empire. The original practices were called anumarana, and were uncommon. Anumarana was not comparable to later understandings of sati, since the practices were not restricted to widows — rather, anyone, male or female, with personal loyalty to the deceased could commit suicide at a loved one's funeral. These included the deceased's relatives, servants, followers, or friends. Sometimes these deaths stemmed from vows of loyalty, and bear a slight resemblance to the later tradition of seppuku in Japan.

Widow burning, the practice as understood today, started to become more extensive after the end of the Gupta empire, around A.D. 500 . The rise of the practice has been variously ascribed to the decline of Buddhism in India, the rise of caste-based societies, and introduction by the Huna invaders who contributed to the fall of the Gupta empire.. It has also been attributed to the Muslim conquest of India.

At about this time, instances of sati began to be marked by inscribed memorial stones. The earliest of these are found in Sagar, Madhya Pradesh, though the largest collections date from several centuries later, and are found in Rajasthan. These stones, called devli, or sati-stones, became shrines to the dead woman, who was treated as an object of reverence and worship. They are most common in western India.

By about the 10th century sati, as understood today, was known across much of the subcontinent. It continued to occur, usually at a low frequency and with regional variations, until the early 19th century.

Practice

(i) any widow along with the body of her deceased husband or any other relative or with any article, object or thing associated with the husband or such relative; or

(ii) any woman along with the body of any of her relatives, irrespective of whether such burning or burying is claimed to be voluntary on the part of the widow or the women or other-wise

The act of sati is said to exist voluntarily; from the existing accounts, many of these acts do indeed occur voluntarily. The act may have been expected of widows in some communities, and the extent to which social pressures or expectations constitute compulsion has been much debated in modern times. However, there were also instances where the wish of the widow to commit sati was not welcomed by others, and where efforts were made to prevent the death.

Traditionally, a person's funeral would have occurred within a day of the death, requiring decisions about sati to be made by that time. When the husband died elsewhere, the widow might still die by immolation at a later date.

Sati often emphasized the marriage between the widow and her deceased husband. For instance, rather than mourning clothes, the to-be sati was often dressed in marriage robes or other finery. In the preliminaries of the related act of Jauhar, both the husbands and wives have been known to dress in their marriage clothes and re-enact their wedding ritual, before going to their separate deaths.

Accounts describe numerous variants in the sati ritual. The majority of accounts describe the woman seated or lying down on the funeral pyre beside her dead husband. Many other accounts describe women walking or jumping into the flames after the fire had been lit, and some describe women seating themselves on the funeral pyre and then lighting it themselves.

Some written instructions for the ritual exist. For instance, the Yallajeeyam provides detailed instructions about who may commit sati, cleansing for the sati, positioning, attire, and other ritual aspects.

Compulsion

Sati was supposed to be voluntary, but it is agreed that in many cases it may not have been voluntary in practice. Setting aside the issue of social pressures, many accounts exist of women being physically forced to their deaths.

Pictorial and narrative accounts often describe the widow being seated on the unlit pyre, and then tied or otherwise restrained to keep her from fleeing after the fire was lit. Some accounts state that the woman was drugged. One account describes men using long poles to prevent a woman from fleeing the flames.

Royal funerals

Royal funerals sometimes have included the deaths of many wives and concubines. A number of examples of these occur in the history of Rajasthan.

Maharani Raj Rajeshwari Devi of Nepal became regent in 1799 in the name of her son, after the abdication of her husband, who became a sanyasi. Her husband returned and took power again in 1804. In 1806 he was assassinated by his brother, and ten days later on 5 May 1806, his widow was forced to commit sati.

Symbolic sati

There have been accounts of symbolic sati in some Hindu communities. A widow lies down next to her dead husband, and certain parts of both the marriage ceremony and the funeral ceremonies are enacted, but without her death.

Jauhar

The Rajput practice of Jauhar, known from Rajasthan and Madhya Pradesh was the collective suicide of a community facing certain defeat in war. It consisted of the mass immolation of women, children, the elderly and the sick, at the same time that their fighting men died in battle.

Burials

In some Hindu communities, it is conventional to bury the dead. Deaths of widows have been known to occur in these communities, with the widow being buried alive beside her husband, in ceremonies that are largely the same as those performed in an immolation.

Prevalence

Records of sati exist across most of the subcontinent. However, there seem to have been major differences historically, in different regions, and among different communities.

Numbers

There are no reliable figures for the numbers who died by sati across the country. A local indication of the numbers is given in the records kept by the Bengal Presidency of the British East India Company. The total figure of known occurrences for the period 1813 to 1828 is 8,135,; another source gives a comparable number of 7,941 from 1815 to 1828, thus giving an average of about 507 to 567 documented incidents per year in that period. Raja Ram Mohan Roy estimated that there were ten times as many cases of Sati in Bengal compared to the rest of the country. Bentinck, in his 1829 report, states that 420 occurrences took place in one (unspecified) year in the 'Lower Provinces' of Bengal, Bihar and Orissa, and 44 in the 'Upper Provinces' (the upper Gangetic plain). Given a population of over 50 million at the time for the Presidency, this suggests a maximum frequency of immolation among widows of well under 1%.

Communities

It is said by some authorities that the practice was more common among the higher castes, and among those who considered themselves to be rising in social status. It was little known or unknown in most of the population of India and the tribal groups, and little known or unknown in the lowest castes. According to at least one source, it was very rare for anyone in the later Mughal empire except royal wives to be burnt. However, it has been said elsewhere that it was unusual in higher caste women in the south.

Regional variations

It was known in Rajasthan from the earliest (6th century) to the present. About half the known sati stones (about 150 in total) in India are in Rajasthan. However, the extent to which individual instances of deaths resulted in veneration (glorification) implies that was not very common.

It is known to have occurred in the south from the 9th century through the period of the Vijayanagara empire. Madhavacharya, who is probably the best known of those historical figures who justified the practice, was originally a minister of the court of this empire. The practice continued to occur after the collapse of the empire, though apparently at a fairly low frequency. In one istance more than fifty women commited Sati in Hampi after the the war of Talikot. In the North-Western Karnataka about fifteen sati stones brought from Vijayanagara can be found. The actual immolation of widows might have taken place elsewhere. The relatives of Sati when they migrated took Sati stones along with them and resurrected at their new abodes. A record exists of a minister of the kingdom of Mysore giving permission for a widow to commit sati in 1805.

In the Upper Gangetic plain, while it occurred, there is no indication that it was especially widespread. The earliest known attempt by a government to stop the practice took place here, that of Muhammad Tughlaq, in the Sultanate of Delhi in the 14th century.

In the Lower Gangetic plain, the practice may have reached a high level fairly late in history. Based on available evidence and the existing reports of the occurrences of it, the greatest incidence of sati in any region and period, in terms of total numbers, occurred in Bengal and Bihar in the late 18th and early 19th centuries. This was during the earlier period of British rule, and before its formal abolition. The Bengal Presidency kept records from 1813 to 1829. The frequency increased in periods of hardship and famine. Ram Mohan Roy suggested that it was more prevalent in Bengal than in the rest of the subcontinent. An unusually large number of the surviving reports for this period are from Bengal, also suggesting that it was most common there.

In modern times, sati has been largely confined to Rajasthan, mostly in or near Shekhawati, with a few instances in the Gangetic plain.

Recent incidence

Sati still occurs occasionally, mostly in rural areas. About 40 cases have been documented as having occurred in India since independence in 1947, the majority in the Shekhawati region of Rajasthan.

A well documented case from 1987 was that of 18-year old Roop Kanwar. In response to this incident, some more recent legislation against the practice was passed, first by the state government of Rajasthan, then by the central government of India.

On 18 May2006, Vidyawati, a 35-year-old woman allegedly committed sati by jumping into the blazing funeral pyre of her husband in Rari-Bujurg Village, Fatehpur district in the State of Uttar Pradesh.
On 21 August2006, Janakrani, a 40-year-old woman, burnt to death on the funeral pyre of her husband Prem Narayan in Sagar district.

Justifications and criticisms

Brahmin scholars of the second millennium justified the practice, and gave reasonings as to how the scriptures could be said to justify them. Among them were Vijnanesvara, of the Chalukya court, and later Madhavacharya, theologian and minister of the court of the Vijayanagara empire, according to Shastri, who quotes their reasoning. It was lauded by them as required conduct in righteous women, and it was explained that this was considered not to be suicide (suicide was otherwise variously banned or discouraged in the scriptures). It was deemed an act of peerless piety, and was said to purge the couple of all accumulated sin, guarantee their salvation and ensure their reunion in the afterlife.

Law books

These are relatively late works. Justifications for the practice are given in the Vishnu Smriti.

Now the duties of a woman (are) ... After the death of her husband, to preserve her chastity, or to ascend the pile after him.

There is also justification in the later work of the Brihaspati Smriti (25-11). Both this and the Vishnu Smriti date from the first millennium.

The Manu Smriti is often regarded as the culmination of classical Hindu law, and hence its position is important. It does not mention or sanction sati though it does prescribe life-long asceticism for most widows.

Scriptures

Although the myth of the goddess Sati is that of a wife who dies by her own volition on a fire, this is not a case of the practice of sati. The goddess was not widowed, and the myth is quite unconnected with the justifications for the practice.

The Puranas have examples of women who commit sati and there are suggestions in them that this was considered desirable or praiseworthy: A wife who dies in the company of her husband shall remain in heaven as many years as there are hairs on his person. (Garuda Purana 1.107.29) According to 2.4.93 she stays with her husband in heaven during the rule of 14 Indras, i.e. a kalpa.

In the Ramayana, Tara, in her grief at the death of husband Vali, wished to commit sati. Hanuman, Rama, and the dying Vali dissuade her and she finally does not immolate herself.

In the Mahabharata, Madri, the second wife of Pandu, immolates herself. She holds herself responsible for the death of her husband, who had been cursed with death if he ever had intercourse. He died while performing the forbidden act with Madri, who blamed herself for not having rejected his advances, although she was well aware of the curse.

Passages in the Atharva Veda, including 13.3.1, offer advice to the widow on mourning and her life after widowhood, including her remarriage.

Argument that the Rig Veda sanctions sati

It is often claimed that this most ancient text sanctions or prescribes sati. This is based on verse 10.18.7, part of the verses to be used at funerals. Whether they even describe sati or something else entirely, is disputed, The hymn is about funeral by burial, and not by cremation. There are differing translations of the passage. The translation below is one of those said to prescribe it.

इमा नारीरविधवाः सुपत्नीराञ्जनेन सर्पिषा संविशन्तु |

अनश्रवो.अनमीवाः सुरत्ना आ रोहन्तु जनयोयोनिमग्रे || (RV 10.18.7)

Let these women, whose husbands are worthy and are living, enter the house with ghee (applied) as collyrium (to their eyes). Let these wives first step into the pyre, tearless without any affliction and well adorned.

The text does not mention widowhood, and other translations differ in their translation of the word here rendered as 'pyre' (yoni, literally "seat, abode"; Griffith has "first let the dames go up to where he lieth"). In addition, the following verse, which is unambiguously about widows, then contradicts any suggestion of the woman's death; it explicitly states that the widow should return to her house.

उदीर्ष्व नार्यभि जीवलोकं गतासुमेतमुप शेष एहि |

हस्तग्राभस्य दिधिषोस्तवेदं पत्युर्जनित्वमभि सम्बभूथ || (RV 10.18.8)

Rise, come unto the world of life, O woman — come, he is lifeless by whose side thou liest. Wifehood with this thy husband was thy portion, who took thy hand and wooed thee as a lover.

A reason given for the discrepancy in translation and interpretation of verse 10.18.7, is that one consonant in a word that meant house, yonim agree "foremost to the yoni", was deliberately changed by those who wished claim scriptural justification, to a word that meant fire, yomiagne.

Counter-arguments within Hinduism

No early descriptions or criticisms of the practice within Hinduism, (or in the other native religions of Buddhism or Jainism), are known before the Gupta period, as the practice was little known at that time.

Explicit criticisms later in the first millennium, included that of Medhatithi, a commentator on various theological works. He considered it suicide, which was forbidden by the Vedas

One shall not die before the span of one's life is run out,

Another critic was Bana, who wrote during the reign of Harsha. Bana condemned it both as suicide, and as a pointless and futile act.

Reform and bhakti movements within Hinduism tended to be anti-caste, favoured egalitarian societies, and in line with the tenor of these beliefs, they generally condemned the practice, sometimes explicitly. The Alvars condemned sati, in the 8th century. The Virashaiva movement in the 12th and 13th centuries, also condemned it.

In the early 19th century, Ram Mohan Roy wrote and disseminated arguments that the practice was not part of Hinduism, as part of his campaign to ban the practice.

Non-Hindu views and criticisms

The Sikh religion explicitly proscribed the practice, by about 1500 AD.

The principal early foreign visitors to the subcontinent who left records of the practice, were from Western Asia, mostly Muslim, and later on, Europeans. Both groups were fascinated by the practice, and they sometimes described it as horrific, but they also often described it as an incomparable act of devotion. Ibn Battuta described an instance, but said that he collapsed or fainted and had to be carried away from the scene. European artists in the eighteenth century produced many images for their own native markets, showing the widows as heroic women, and moral exemplars.

As Islam established itself in the subcontinent, opinions about sati changed and it was increasingly regarded as a barbaric practice. The earliest known governmental efforts to halt the practice were undertaken by Muslim rulers, including Muhammad Tughlaq.

Europeans also showed a change in their attitudes regarding local customs as their home countries became dominant local powers. The earliest Europeans to establish themselves were the Portuguese in Goa. They tried early on to override local customs and practices, including sati, as they attempted to Christianise territories in their control. The British entered India as a trading body, and in the earlier periods of their rule, they were largely indifferent to local practices. The practice of sati, and its later legal abolition by the British (along with the suppression of the thuggee) went on to become one of the standard justifications for British rule. British attitudes in their later history in India are usually given in the following much repeated quote, usually ascribed to General Napier -

You say that it is your custom to burn widows. Very well. We also have a custom: when men burn a woman alive, we tie a rope around their necks and we hang them. Build your funeral pyre; beside it, my carpenters will build a gallows. You may follow your custom. And then we will follow ours.

Suppression

Mughal period

Akbar required that permission be granted by his officials, and these officials were instructed to delay the woman's decision for as long as possible. The reasoning was that she was less likely to choose to die once the emotions of the moment had passed. In the reign of Shah Jahan, widows with children were not allowed to burn under any circumstances . In other cases, governors did not readily give permission, but could be bribed to do so. Later on in the Mughal period, pensions, gifts and rehabilitative help were offered to the potential sati to wean her away from committing the act. Children were strictly forbidden from following the practice. The later Moghul rulers continued to put obstacles in the way but the practice still persisted in areas outside their capitals.

Guru Nanak, the first Guru of the Sikhs spoke out against the practice of sati.

The strongest attempts to control it were made by Aurangzeb. In 1663, he "issued an order that in all lands under Mughal control, never again should the officials allow a woman to be burnt". Despite such attempts however, the practice continued, especially during periods of war and upheaval.

British and other European territories

By the end of the 18th century, the practice had been banned in territories held by some European powers. The Portuguese banned the practice in Goa by about 1515, though it is not believed to have been especially prevalent there. The Dutch and the French also banned it in Chinsurah and Pondicherry. The British who by then ruled much of the subcontinent, and the Danes, who held the small territories of Tranquebar and Serampore, permitted it until the 19th century.
Attempts to limit or ban the practice had been made by individual British officers in the 18th century, but without the backing of the British East India Company. The first formal British ban was imposed in 1798, in the city of Calcutta only. The practice continued in surrounding regions. Toward the end of the 18th century, the evangelical church in Britain, and its members in India, started campaigns against sati. Leaders of these campaigns included William Carey and William Wilberforce, and both appeared to be motivated partly by a desire to convert Indians to Christianity. These movements put pressure on the company to ban the act, and the Bengal Presidency started collecting figures on the practice in 1813.

From about 1812, the Bengali reformer Raja Rammohan Roy started his own campaign against the practice. He was motivated by the experience of seeing his own sister-in-law commit sati. Among his actions, he visited Calcutta cremation grounds to persuade widows not to so die, formed watch groups to do the same, and wrote and disseminated articles to show that it was not required by scripture.

On 4 December, 1829, the practice was formally banned in the Bengal Presidency lands, by the then governor, Lord William Bentinck. The ban was challenged in the courts, and the matter went to the Privy Council in London, but was upheld in 1832. Other company territories also banned it shortly after. Although the original ban in Bengal was fairly uncompromising, later in the century British laws include provisions that provided mitigation for murder when "the person whose death is caused, being above the age of 18 years, suffers death or takes the risk of death with his own consent".

Sati remained legal in some princely states for a time after it had been abolished in lands under British control. The last such state to permit it, Jaipur, banned the practice in 1846.

Modern times

Following outcries after each instance, there have been various fresh measures passed against the practice, which now effectively make it illegal to be a bystander at an event of sati. The law now makes no distinction between passive observers to the act, and active promoters of the event; all are supposed to be held equally culpable. Other measures include efforts to stop the 'glorification' of the dead women. Glorification includes the erection of shrines to the dead, the encouragement of pilgrimages to the site of the pyre, and the derivation of any income from such sites and pilgrims.

Following the outcry after the Sati of Roop Kanwar, the Indian Government enacted the Rajasthan Sati Prevention Ordinance, 1987 on October 11987 and later passed the Commission of Sati (Prevention) Act, 1987.

The Prevention of Sati Act makes it illegal to abet, glorify or attempt to commit Sati. Abetment of Sati, including coercing or forcing someone to commit Sati can be punished by Death Sentence or Life imprisonment, while glorifying Sati is punishable with 1-7 years in Prison.

However, enforcement of these measures is not always consistent. Prohibitions of certain practices, such as worship at ancient shrines, is a matter of controversy The National Council for Women (NCW) has suggested amendments to the law to remove some of these flaws.

Notes

The spelling suttee is a phonetic spelling using the 19th century English orthography. However the sati transliteration is correct using the more modern IAST (International Alphabet of Sanskrit Transliteration) which is the academic standard for writing the Sanskrit language with the Latin alphabet system.